title: Initial experience with robotic gasless transaxillary thyroidectomy for the management of graves disease: comparison of conventional open versus robotic thyroidectomy.
abstract: OBJECTIVE
  The aim of this study was to report on our initial experiences with robotic gasless transaxillary thyroidectomy for the management of Graves disease (GD).
  
  
  METHODS
  Among 257 patients with benign thyroid diseases who underwent thyroidectomy, 16 patients who underwent thyroidectomy for GD were analyzed from January 2009 to December 2010. These patients included 7 individuals who underwent robotic gasless transaxillary thyroidectomy (robot group; RG) and 9 who underwent conventional open thyroidectomy (open group; OG). Regardless of the type of surgery, all patients underwent subtotal thyroidectomy. The clinical characteristics and surgical outcomes of the 2 groups were compared.
  
  
  RESULTS
  Patients in the RG were significantly younger at the time of surgery compared with those in the OG (P=0.028). The mean operative time was 171.29±18.88 minutes for the RG and 89.44±7.08 minutes for the OG (P=0.001). The mean weight of the resected glands was 77.43±12.29 g for the RG and 85.56±20.37 g for the OG (P=0.896). The RG had a significantly shorter mean hospitalization period of 3.0±0 days compared with 3.78±0.22 days of the OG. The mean number of times analgesics were used for pain control were 2.43±0.29 for the RG and 4.0±0.52 for the OG (P=0.039). No cases in the RG were converted to open thyroidectomy. During a mean follow-up period of 14.43±1.49 months for the RG, no patients continued antithyroid drugs or developed recurrent GD.
  
  
  CONCLUSIONS
  Robotic gasless transaxillary thyroidectomy is a technically feasible and safe procedure for the patients with GD that results in a scarless outcome on the neck. This procedure can be a promising alternative for endoscopic or conventional open thyroidectomy for the management of GD.
authors.affiliation: Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Jae Hyun
authors.initials: JH
authors.lastname: Park
authors.forename: Cho-Rok
authors.initials: CR
authors.lastname: Lee
authors.forename: Seulkee
authors.initials: S
authors.lastname: Park
authors.forename: Jun Soo
authors.initials: JS
authors.lastname: Jeong
authors.forename: Sang-Wook
authors.initials: SW
authors.lastname: Kang
authors.forename: Jong Ju
authors.initials: JJ
authors.lastname: Jeong
authors.forename: Kee-Hyun
authors.initials: KH
authors.lastname: Nam
authors.forename: Woong Youn
authors.initials: WY
authors.lastname: Chung
authors.forename: Cheong Soo
authors.initials: CS
authors.lastname: Park
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005240:Feasibility Studies; D005260:Female; D006111:Graves Disease / Q000601:surgery*; D006801:Humans; D006996:Hypocalcemia / Q000209:etiology; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000209:etiology; D012371:Robotics / Q000379:methods*; D013965:Thyroidectomy / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult